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NPI Code Detail

MEDICARE: MS. TERESA WEI-LAN LOW OTR/L

MEDICARE: MS. TERESA WEI-LAN LOW OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist003290CT
2225XP0200XPediatric Occupational Therapist011370-1NY

General Provider Information

NPI Number : 1336392992
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TERESA WEI-LAN LOW OTR/L
Provider Business Mailing Address
First Line : 26 HEATHER DR
Second Line :
City : MAHOPAC
State : NY
Zip : 10541-2120
Country : US
Telephone Number : 845-628-3235
Fax Number :
Provider Business Practice Location Address
First Line : 15 MOUNT EBO RD S
Second Line :
City : BREWSTER
State : NY
Zip : 10509-4004
Country : US
Telephone Number : 845-940-1810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2008
Last Update Date : 10/28/2008

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1326292178 — MS. AIMEE L. MARTINE LMSW
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